The California Hospital Association (CHA) was surprised and disappointed when Sutter Health was served in 2009 with a lawsuit by Rockville Recovery Associates LTD over its chronometric (time based) approach to billing for anesthesia services. More than 90 percent of hospitals in California, including state-owned hospitals, bill in the same manner and use the same billing codes. CHA filed an amicus brief in May 2013 to alert the court that chronometric billing is the industry standard and that hospitals are following state and federal guidelines.

In an era when health care providers are working diligently to improve quality and reduce costs, lawsuits such as these are an unfortunate diversion of resources better spent on patient care, needed equipment and wages and benefits for employees.

Sutter Health, like many organizations in similar situations, ultimately concluded that the certainty of a settlement was the most prudent path to bring closure to this issue. As part of the settlement, Sutter Health agreed to bill for anesthesia services at a flat rate, as opposed to the traditional time-based process. To the extent this approach serves to simplify or provide more transparency and predictability for patients, hospitals will likely evaluate the benefits of following a similar methodology.